Cargando…

Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial

OBJECTIVES: To determine the efficacy of platelet-rich plasma (PRP) compared to lidocaine as a tenotomy adjuvant for people with elbow tendinopathy. METHODS: Our study was a parallel-group, double-blind, randomized trial involving 71 patients with recalcitrant elbow tendinopathy who received two ses...

Descripción completa

Detalles Bibliográficos
Autores principales: Martin, Jose Ignacio, Atilano, Leire, Merino, Josu, Gonzalez, Igor, Iglesias, Gotzon, Areizaga, Luis, Bully, Paola, Grandes, Gonzalo, Andia, Isabel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480601/
https://www.ncbi.nlm.nih.gov/pubmed/31014382
http://dx.doi.org/10.1186/s13018-019-1153-6
_version_ 1783413602898673664
author Martin, Jose Ignacio
Atilano, Leire
Merino, Josu
Gonzalez, Igor
Iglesias, Gotzon
Areizaga, Luis
Bully, Paola
Grandes, Gonzalo
Andia, Isabel
author_facet Martin, Jose Ignacio
Atilano, Leire
Merino, Josu
Gonzalez, Igor
Iglesias, Gotzon
Areizaga, Luis
Bully, Paola
Grandes, Gonzalo
Andia, Isabel
author_sort Martin, Jose Ignacio
collection PubMed
description OBJECTIVES: To determine the efficacy of platelet-rich plasma (PRP) compared to lidocaine as a tenotomy adjuvant for people with elbow tendinopathy. METHODS: Our study was a parallel-group, double-blind, randomized trial involving 71 patients with recalcitrant elbow tendinopathy who received two sessions of ultrasound-guided tenotomy with either PRP or lidocaine in a tertiary public hospital. The primary end point was the percentage of patients with an improvement exceeding 25% reduction in disability (Spanish version of the Disabilities of the Arm, Shoulder and Hand questionnaires–DASH-E) at 6 and 12 months; the secondary outcome was the percentage of patients exceeding 25% reduction in pain (VAS-P). RESULTS: There was no evidence of significant differences in the proportion of patients who experienced clinically relevant improvements. After 6 months, 18 patients (78.59%) in the lidocaine group and 19 patients (73.08%) in the PRP group showed improved function above 25% (unadjusted odds ratio, 0.90; 95% confidence interval [CI], 0.90 (0.17 to 4.60)); 21 patients (72.21%) in the lidocaine group versus 22 patients (84.62%) in the PRP group achieved more than 25% pain reduction (unadjusted odds ratio, 0.48; 95% CI, 0.10 to 2.37). After 12 months, 17 patients (70.83%) in the lidocaine group versus 19 patients (76%) in the PRP group had improved function (unadjusted odds ratio, 0.71; 95% CI, 0.13 to 3.84), and 19 patients (76%) in the lidocaine group versus 20 patients (90.91%) in the PRP group had improved pain above 25% (unadjusted odds ratio, 0.35; 95% CI, 0.06 to 2.51). Hypercholesterolemia and baseline vascularization influenced outcomes. There were no differences between groups in the adjusted odds ratios. CONCLUSION: PRP results in similar improvements to those obtained with lidocaine. Selecting patients according to their pretreatment status can improve treatment efficacy. TRIAL REGISTRATION: NCT01945528, EudraCT 2013-000478-32. Registered 18 August 2013, enrolment of the first participant 10 March 2014
format Online
Article
Text
id pubmed-6480601
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-64806012019-05-01 Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial Martin, Jose Ignacio Atilano, Leire Merino, Josu Gonzalez, Igor Iglesias, Gotzon Areizaga, Luis Bully, Paola Grandes, Gonzalo Andia, Isabel J Orthop Surg Res Research Article OBJECTIVES: To determine the efficacy of platelet-rich plasma (PRP) compared to lidocaine as a tenotomy adjuvant for people with elbow tendinopathy. METHODS: Our study was a parallel-group, double-blind, randomized trial involving 71 patients with recalcitrant elbow tendinopathy who received two sessions of ultrasound-guided tenotomy with either PRP or lidocaine in a tertiary public hospital. The primary end point was the percentage of patients with an improvement exceeding 25% reduction in disability (Spanish version of the Disabilities of the Arm, Shoulder and Hand questionnaires–DASH-E) at 6 and 12 months; the secondary outcome was the percentage of patients exceeding 25% reduction in pain (VAS-P). RESULTS: There was no evidence of significant differences in the proportion of patients who experienced clinically relevant improvements. After 6 months, 18 patients (78.59%) in the lidocaine group and 19 patients (73.08%) in the PRP group showed improved function above 25% (unadjusted odds ratio, 0.90; 95% confidence interval [CI], 0.90 (0.17 to 4.60)); 21 patients (72.21%) in the lidocaine group versus 22 patients (84.62%) in the PRP group achieved more than 25% pain reduction (unadjusted odds ratio, 0.48; 95% CI, 0.10 to 2.37). After 12 months, 17 patients (70.83%) in the lidocaine group versus 19 patients (76%) in the PRP group had improved function (unadjusted odds ratio, 0.71; 95% CI, 0.13 to 3.84), and 19 patients (76%) in the lidocaine group versus 20 patients (90.91%) in the PRP group had improved pain above 25% (unadjusted odds ratio, 0.35; 95% CI, 0.06 to 2.51). Hypercholesterolemia and baseline vascularization influenced outcomes. There were no differences between groups in the adjusted odds ratios. CONCLUSION: PRP results in similar improvements to those obtained with lidocaine. Selecting patients according to their pretreatment status can improve treatment efficacy. TRIAL REGISTRATION: NCT01945528, EudraCT 2013-000478-32. Registered 18 August 2013, enrolment of the first participant 10 March 2014 BioMed Central 2019-04-23 /pmc/articles/PMC6480601/ /pubmed/31014382 http://dx.doi.org/10.1186/s13018-019-1153-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Martin, Jose Ignacio
Atilano, Leire
Merino, Josu
Gonzalez, Igor
Iglesias, Gotzon
Areizaga, Luis
Bully, Paola
Grandes, Gonzalo
Andia, Isabel
Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial
title Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial
title_full Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial
title_fullStr Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial
title_full_unstemmed Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial
title_short Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial
title_sort platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow epicondylopathy: a randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480601/
https://www.ncbi.nlm.nih.gov/pubmed/31014382
http://dx.doi.org/10.1186/s13018-019-1153-6
work_keys_str_mv AT martinjoseignacio plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT atilanoleire plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT merinojosu plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT gonzalezigor plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT iglesiasgotzon plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT areizagaluis plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT bullypaola plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT grandesgonzalo plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial
AT andiaisabel plateletrichplasmaversuslidocaineastenotomyadjuvantsinpeoplewithelbowepicondylopathyarandomizedcontrolledtrial